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LIC 508 - Criminal Record Statement

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCYCALIFORNIA DEPARTMENT OF SOCIAL SERVICESCOMMUNITY CARE LICENSING DIVISIONCRIMINAL Record STATEMENTS tate law requires that persons associated with licensed facilities or Home Care Aide Registry applicants be fingerprinted and disclose any conviction. A conviction is any plea of guilty or nolo contendere (no contest) or a verdict of guilty. Thefingerprints will be used to obtain a copy of any Criminal history you may you ever been convicted of a crime in California ? .. YES NOYou need not disclose any marijuana-related offenses covered by the marijuana reform legislation codified at Health and Safety Codesections and you ever been convicted of a crime from another state, federal court,military or jurisdiction outside of.

a criminal background check. (Health and Safety Code sections 1522, 1568.09, 1569.17, 1596.871, and 1796.19). The Department will create a file concerning your criminal background check that will contain certain documents,

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